Idaho health insurance Marketplace guide

In order to sign up for private health coverage through Your Health Idaho, you must:⁴

• Be an Idaho resident and lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare⁵

So most Idaho residents are eligible to enroll in coverage through the exchange. But eligibility for financial assistance is a bigger question for most people, and there are a few additional eligibility rules to qualify for subsidies through Your Health Idaho. 

To qualify for income-based Advance Premium Tax Credits (APTC) or cost-sharing reductions (CSR), you must:

• Not be eligible to enroll in an affordable employer-sponsored health plan. If you have access to an employer’s health plan and aren’t sure if it’s considered affordable, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies to offset the cost of a Your Health Idaho plan. 
• Not be eligible for Idaho Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁶
• If married, file a joint tax return.⁷
• Not be able to be claimed by someone else as a tax dependent.⁷

Beyond those basic parameters, qualifying for Your Health Idaho’s subsidies will depend on your household’s income. Here’s how that’s calculated under the ACA.

Your Health Idaho’s open enrollment runs from October 15 to December 15.⁸ Both the start and end dates differ from the schedule that’s used in other states. 

Starting in the fall of 2026, for coverage effective in 2027 and future years, HealthCare.gov will have an open enrollment period that runs from November 1 through December 15. All plans selected during open enrollment will take effect January 1, and state-run exchanges will not be allowed to extend open enrollment past December 31.

Idaho will be able to continue to use the October 15 to December 15 schedule, as that fits with the new federal rules that require open enrollment to start no later than November 1 and end no later than December 31, starting in the fall of 2026.⁹

After open enrollment ends, you may still be eligible to enroll or make a plan change, but only if you qualify for a special enrollment period. 

Most special enrollment periods are triggered by qualifying life events, such as giving birth or losing other health coverage. However, Native Americans are eligible for a special enrollment period without a specific qualifying life event.

Enrollment in Idaho Medicaid and CHIP is available year-round for eligible residents.

To enroll in an ACA Marketplace/exchange plan in Idaho, you can: 

• Visit Your Health Idaho, which is Idaho’s health insurance exchange (Marketplace). The Your Health Idaho website will allow you to compare available health plans, determine whether you’re eligible for financial assistance, and enroll in a health plan. 
• Enroll in a Your Health Idaho plan with the help of an insurance broker or certified enrollment counselor.

You can reach Your Health Idaho’s call center at 855-944-3246.

Income-based subsidies (APTC, created by the Affordable Care Act) are available to lower the amount you pay for your health coverage each month. These subsidies are available to enrollees who meet the eligibility requirements and select a metal-level health plan through Your Health Idaho.

Eighty-six percent of the people who enrolled through Your Health Idaho during open enrollment for 2025 coverage were eligible for premium subsidies. These subsidies paid an average of $411/month, reducing the average enrollee’s premium (including those who pay full price) to about $129/month.¹⁰

Source: CMS.gov¹⁰

Although most Your Health Idaho enrollees qualify for premium subsidies, the state’s reinsurance program helps to keep full-price premiums lower than they would otherwise be, making coverage more affordable for people who have to pay full price.¹¹

If your household doesn’t earn more than 250% of the federal poverty level, you’ll also be eligible for federal cost-sharing reductions (CSR) as long as you select a Silver-level plan through Your Health Idaho. These subsidies will reduce your deductible and other out-of-pocket expenses, making health care more affordable. More than a third of Your Health Idaho enrollees were receiving CSR benefits as of early 2025.¹²

If you’re eligible for APTC and CSR, you can use them both if you enroll in a Silver-level plan through Your Health Idaho (APTC can be used with any metal-level plan, but you can only get CSR benefits if you enroll in a Silver plan). 

Depending on your income and circumstances, you may be able to enroll in free or low-cost health coverage through Idaho Medicaid or CHIP. Learn more about whether you might be eligible for Medicaid and CHIP in Idaho.

For 2026 coverage, eight insurers will offer exchange plans in Idaho, with varying coverage areas.² These are the same eight insurers that offered coverage for 2025.³

For 2026, the following average rate changes have been proposed by Idaho’s Marketplace insurers, amounting to a preliminary overall average rate increase of 10%, before any subsidies are applied.² (Note that this is less than half the nationwide preliminary percentage rate increase for 2026.)¹³

Source: Idaho Department of Insurance²

Average rate changes apply to full-price rates, and most enrollees do not pay full price: Eighty-seven percent of Your Health Idaho enrollees qualified for advance premium subsidies in 2025, offsetting some or all of their monthly premium cost.¹⁴

Subsidy amounts vary from one enrollee to another and change annually depending on the cost of the second-lowest-cost Silver plan relative to the enrollee’s household income. The American Rescue Plan and the Inflation Reduction Act have resulted in larger, more widely available subsidies through 2025. 

But unless Congress takes action to extend the subsidy enhancements, subsidies will shrink in 2026 and some people will lose their subsidies altogether. If the subsidy enhancements are allowed to expire, net (after subsidy) premiums will increase drastically for nearly all Marketplace enrollees.

Here’s an overview of how average pre-subsidy premiums have changed over the years in Idaho’s individual/family market:

• 2016: Average increase of 20%¹⁵
• 2017: Average increase of 24%¹⁶
• 2018: Average increase of 27%¹⁷
• 2019: Average increase of 5%¹⁸
• 2020: Average increase of 6.3%¹⁹
• 2021: Average increase of 1%²⁰
• 2022: Average decrease of 2%²¹
• 2023: Average decrease of 3.6%²² (reinsurance program took effect)
• 2024: Average decrease of 1%²³
• 2025: Average increase of 5%³ 

During the open enrollment period for 2025 coverage, 117,373 people selected private plans through Your Health Idaho.²⁴

 This was a record high for Idaho’s Marketplace.

Source: 2014,²⁵ 2015,²⁶ 2016,²⁷ 2017,²⁸ 2018,²⁹ 2019,³⁰ 2020,³¹ 2021,³² 2022,³³ 2023,³⁴ 2024,³⁵ 2025²⁴

Your Health Idaho – This is the state-based exchange/Marketplace in Idaho, where you can compare plans, determine financial assistance eligibility, and select a health plan. You can reach Your Health Idaho at 855-YHIdaho (855-944-3246)

State Exchange Profile: Idaho – The Henry J. Kaiser Family Foundation overview of Idaho’s progress toward creating a state health insurance exchange.

Idaho Department of Insurance – Regulates the insurance industry in Idaho, and addresses consumers’ questions and complaints related to insurance.
(208) 334-4250 / toll-free (800) 721-3272.

Idaho Senior Health Insurance Benefits Advisors – A service for Idaho Medicare beneficiaries and their caregivers, providing information and assistance with questions related to Medicare eligibility, enrollment, and claims.